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ABOS > Miller's Spine > Flashcards

Miller's Spine Flashcards

1
Q

axis of rotation of compression fx

A

middle column

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2
Q

MOA for Burst fx

A

axial

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3
Q

Axis or rotation for flexion and distraction

A

anterior longitudinal ligament

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4
Q

burst fc in pt that is neuro intact with minimal deformity

- board brace answer?

A

can be treated in extension bracing

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5
Q

Burst

- ant vs post?

A

Ant- neuro deficit with retropulsion

post - multiseg fication, lamina fx

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6
Q

bony chance
ligamentous chance
Treatment for each

A

extension bracing

posterior tension band

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7
Q

% of those with asymptomatic disc herniation on MRI

A

25-37%

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8
Q

movement causing disc pain

movement causing facet pain

A

disc-> flexion

facet-> extension

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9
Q

most sensitive method for detecting isthmic spondy

A

SPECT

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10
Q

nerve that innervates facet joint

A

medial branch of dorsal primary rami and sinuvertebral n

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11
Q

most common nerve affected with L5/S1 isthimic spondy

- whats it from

A

exiting L5 nerve root

- due to a fibrocartilaginous reparative process under the pars

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12
Q

causes of iatragenic isthimic spondy

A

burr through the pars
removal of 100% of one facet
removal of 50% of bilateral facet

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13
Q

treatment for lateral recess stenosis

- causes unilateral nerve root pain

A

medial facetectomy

- preserve the pars

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14
Q

Surgical treatment for thoracic HNP

A

costotransversectomy
transthoracic approach

isolated laminectomy NOT the answer

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15
Q

main cause of epidural abscess

clinical presentation compared to diskitis

A

operative cause
ESI
Lumbar puncture
more systemically ill

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16
Q

contents of carotid sheath

A

internal and common carotid a
internal jugular vein
vagus n

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17
Q

finding on laryngoscope that suggest vocal cord is paralysized

A

Adducted -> abnormal

abducted they are normal

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18
Q

Difference in injury to superior vs recurrent laryngeal n

A

superior
- upper cervical serugery
- high note phonation NOT vocal cord paralysis
recurrent causes vocal cord paralysis

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19
Q

Benefit of TLSO over Jewett brace for thoracolumbar spin fx’s

A

TLSO gives more rotational control

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20
Q

% of people with resolution of acute low back pain by 1 mos

A

90%

21
Q

Most important predictor of successful outcome after diskectomy for lumbar HNP

A

+ straight leg raise

22
Q

low Japanese score

A

higher level of dysfunction from cervical myelopathy

23
Q

finding on MRI C spine indicative of permanent change to spinal cord

A

myelomalacia -> cord enhancement

24
Q

limit of anterior surgery for myelopathy that indicates addition of posterior procedure

A

2 level corpectomy

3 or more levels that need addressed

25
Q

location of screws for cervical fusion

A

C1- lateral mass
C2- pedicle
C3-6 - lateral mass
C7 and down- pedicle

26
Q

orientation of lateral mass screws in C spine

A

up and out

  • out avoids vertebral a
  • up avoids exiting nerve root
27
Q

Cervical level when screws are oriented outward

A

C7

28
Q

Unique to each

  • anterior cervical
  • posterior cervical
A

anterior - dysphagia
posterior - infection

otherwise they have similar rates of other complications
- C5 palsy, progressive myelopathy, durotomy

29
Q

CA to play contact sport

- findings related to cervical stenosis

A

myelomalacia

CSF effacement

30
Q

Indication for surgery for RA cervical C1/2 instability

A

ADI > 10mm
PADI < 14mm
progressive deficits

31
Q

Indication for surgery for RA basilar invagination

A

progressive cranial migration

occiput to cervical fusion

32
Q

% who improve from nonop of cervical radiculopathy

A

75%

33
Q

Operative indication for cervical radiculopathy

A

NOT weakness -> this always improves

persistent and disabling pain for 6-12 wks after failed nonop

34
Q

interval of ACDF

A

SCM lateral medial is strap muscles

35
Q

Risk of adjacent segment disease after C spine fusion

A

1.5-4%

36
Q

Neural crest ->
Neural tube ->
notocord ->

A

PNS, sympathetic trunk
spinal cord
vertebral bodies and disc

37
Q

Positive signal in MEP/SEP

A

MEP
- sustained > 75% decrease in MEP amp

SEP

  • 50% decrease in am
  • 10% increase in latency
38
Q

Radiograph to clear C spine

A

Either

  • XR: AP/lat and open mouth odontoid, gotta image top of T1
  • CT to bottom of 1st thoracic T1 vertebra
39
Q

how to tell difference btw spinal shock and neurogenic shock

A

both with bradycardia and hypotension

- neurogenic shock has intact bulbocavernosus reflex

40
Q

indication for high dose steroid in SCI

A

NO LONGER INDICATED

- complications outweigh potential benefits

41
Q

appropriate timing of surgery for spine injury in setting of SCI

A

incomplete w/in 12 hours

complete w/in 24 hours

42
Q

When to operate on central cord

A

severe compression
worsening exam with mild stenosis
pre-exhisting myelopathy

43
Q

HLA-B8

A

DISH

44
Q

Treatment for cervical diskitis/epidural abcess

A

emergent decompression/stabilization

45
Q

os odontoideum is a CA to…

A

contact sports

46
Q

When to operate on type 2 odontoid
< 50 yo
> 50yo

A

< 50 —> risk factors of nonunion

> 50 –> already met criteria b’c they’re older than 50 making at risk for nonunion

47
Q

combined lateral mass overhang C1 on C2 that meets criteria of instability

A

> 7mm

>8.1mm with magnification

48
Q

difference on lateral C spine xray to help determine diff btw unilateral vs bilateral jumped facet

A

unilateral vert body is 25% subluxed

bilateral will be 50% translated

49
Q

when to do urgent closed reduction for jumped facet of c spine

A

bilateral and alert is only scenario
if unilateral they get MRI first
- reason is bilateral has the high risk of spinal cord injury so you want to do it ASAP
- unilateral no rush, get MRI, then OR

ABOS (14 decks)

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